Drug Interaction Report

Imipenem and Cyclosporine Injection: Interaction Details

Name: Imipenem and Cyclosporine Injection Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Imipenem and Cyclosporine Injection interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Cyclosporine Injection

Atopica Cequa Cyclavance Gengraf Modulis Neoral Optimmune Restasis

Imipenem

No brand names on record

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Moderate

Can be significant — usually manageable with monitoring.

Minor

Moderate

Major

Contraindicated

How we grade severity & evidence

Severity levels

Contraindicated: These should generally not be used together.
Major: Potentially serious — often needs a change or close monitoring.
Moderate: Can be significant — usually manageable with monitoring.
Minor: Usually limited clinical impact.

Evidence grades

Established: Well documented — supported by controlled studies or strong clinical data.
Probable: Good supporting evidence, though not definitively proven.
Suspected: Some evidence suggests this interaction, but it is not well established.
Possible: Limited or conflicting evidence; the interaction may occur.
Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 6 documented Imipenem interactions, 2 are rated moderate — including this one.

Onset

rapid

Evidence

probable

Severity

Moderate

What happens

Neurotoxicity (mental confusion, agitation, tremor)

Interaction Deep Dive

In a case report, concurrent use of imipenem/cilastatin (500 mg every twelve hours) resulted in increased cycloSPORINE levels (from 400 ng/mL to 1000 ng/mL four days after initial therapy) and the development of confusion, agitation, and tremor (20 minutes after second dose of imipenem/cilastatin)²¹.

Why it happens (mechanism)

Decreased metabolism/increased toxicity

Common questions

Can I take Imipenem and Cyclosporine Injection together?

Neurotoxicity (mental confusion, agitation, tremor) Always confirm with your pharmacist or prescriber before making any change.

How serious is the Imipenem and Cyclosporine Injection interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

Does my dose of Imipenem or Cyclosporine Injection need adjusting while I take them together?
What symptoms should prompt me to call you or my prescriber right away?
Does the timing of my doses matter for this combination?
Is there anything you'd monitor while I'm on both?

References (2)

Yee GC & McGuire TR: Pharmacokinetic drug interactions with cyclosporin (Part I). Clin Pharmacokinet 1990; 19:319-332.
Zazgornik J, Schein W, Heimberger K, et al: Potentiation of neurotoxic side effects by coadministration of imipenem to cyclosporine therapy in a kidney transplant recipient. Synergism of side effects or drug interaction?. Clin Nephrol 1986; 26:265-266.

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Cyclosporine Injection

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HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.